1518579689 NPI number — CHARLESTON AREA MEDICAL CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518579689 NPI number — CHARLESTON AREA MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLESTON AREA MEDICAL CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518579689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1547
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLESTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25326-1547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-388-1724
Provider Business Mailing Address Fax Number:
304-388-1721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
702 PROFESSIONAL PARK DR STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUMMERSVILLE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26651-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-872-0035
Provider Business Practice Location Address Fax Number:
304-872-0102
Provider Enumeration Date:
08/20/2020

Additional Information

Authorized Official

Authorized Official Last Name:
BELL
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
ZECHARIAH
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
304-388-6251

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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